MedicalResearch.com Interview with:
Amye Tevaarwerk, M.D.
Assistant Professor of Medicine
University of Wisconsin School of Medicine and Public Health
Carbone Comprehensive Cancer Center
Wisconsin Institute for Medical Research (WIMR)
Medical Research: What is the background for this study? What are the main findings?
Dr. Tevaarwerk: These patients were enrolled on a larger clinical trial known as the Symptom Outcomes and Practice Patterns study (SOAPP). SOAPP recruited breast, prostate, colon and lung cancer patients directly during outpatient oncology follow-up visits. All of the patients were recruited between May 2006 and May 2008.
The parent study recruited 3123 patients, of these 680 patients had metastatic disease and 668 had employment data.
Patients were asked if they were working and if there had been a change due to illness. We were able to compare those stably working with those who had changed to “no longer working” and look at factors that associated with this change (age, gender, cancer type, race/ethnicity, time since diagnosis, location of metastatic disease, type of treatment, performance status, number of metastases, symptom burden.)
Medical Research: What should clinicians and patients take away from your report?
Dr. Tevaarwerk: The most important findings of the study are:
- Hormone therapy was associated with positive employment outcomes.
- Participants receiving chemotherapy, radiation therapy, and/or immunotherapy did not fare worse than those receiving no therapy at all (e.g. such treatments did not associate with negative changes in employment)
- Most importantly, low symptom burden was associated with continued employment. Symptoms and symptom burden may be modifiable (either by better treatment of the symptoms, work place strategies addressing the symptoms or even treatment of the underlying disease).
- This give us potential targets for future intervention studies, designed to improve work ability for metastatic cancer patients.
However, the parent study did not ask patients about the reason(s) for the change in work, and did not collect information about insurance, marital status, education, need to work, etc. Thus, we could not assess the impact of such factors. Such factors are likely important, and are being collected by as part of other clinical trials, which are either currently in progress or planned.
Nevertheless, this study is nearly unique in assessing employment status among a large, and exclusively metastatic patient population that includes the 4 most common adult solid cancers.
Moreover, our findings suggested that there are potential modifiable factors (e.g. high symptom burden) associated with change to “no longer working” and that managing either cancer or treatment related symptoms more aggressively might allow metastatic cancer patients to continue working (if they desire or need to.)
Working after a metastatic cancer diagnosis: factors affecting employment in the metastatic setting from ECOG’s Symptom Outcomes and Practice Patterns (SOAPP) study. Amye Tevaarwerk, Ju-Whei Lee, Abigail Terhaar, Mary Sesto, Mary Lou Smith, Charles Cleeland, and Michael Fisch. CANCER; Published Online: December 21, 2015 (DOI: 10.1002/cncr.29656).
Amye Tevaarwerk, M.D. (2015). Many Patients With Metastatic Cancer Continue To Work